Half of childhood asthma hospitalizations could be prevented with improved parent-physician communication

Each year, some 196,000 children are hospitalized in the United States with asthma attacks. In addition to the severe breathing problems that the children may experience, it also costs the health care system an estimated $835 million to treat them.

A new study by a Medical College of Wisconsin researcher indicates that up to half of childhood asthma hospitalizations could be prevented with improved parent-physician communication regarding the child's condition, medication, follow-up care and asthma triggers.

Results of the studies appeared in the October issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics.

The study was led by Glenn Flores, MD, FAAP, associate professor of pediatrics, epidemiology and health policy at the Medical College in Milwaukee, and director of the Center for the Advancement of Underserved Children, a joint program of the Medical College and Children's Hospital of Wisconsin.

In the study, researchers surveyed parents, doctors and attending physicians of children admitted for asthma to an urban hospital over 14 months. Of the 230 hospitalized children, most were older (median age of five), poor and non-white, with public or private health insurance. Most children had not had a physician visit or contact before hospital admission.

The study showed that 83 percent of primary care physicians, 67 percent of attending physicians and 44 percent of parents cited parent/patient related issues as the reasons why the hospitalizations could have been prevented. It concluded that an estimated 15 to 54 percent of asthma–related hospitalizations are preventable, especially those that involve adolescents and families who had not contacted physicians prior to hospitalization.

"We found that many pediatric asthma hospitalizations could be prevented if parents were better educated about the child's condition, what medications they should be taking, the need for follow-up care, and the importance of avoiding known disease triggers," Dr. Flores says.

About one-third to one-half of preventable asthma hospitalizations were medication related, including adherence problems, running out of medications, and refills not being called in, he notes.

"These striking findings underscore that educating families about sticking to their medication schedule and making sure they don't run out of their supplies may have a significant impact on preventing children from being hospitalized," Dr. Flores says.

Other reasons for the hospitalizations include delays in follow-up care from previous attacks and not knowing or keeping children away from asthma triggers, including cigarette smoke, dust and pets.

"The more we tell parents about asthma and how they can help prevent asthma attacks, the more likely it is that kids won't suffer from preventable hospitalizations. We also have the potential to save between $161 to $581 million in the cost of treating them," he says.